不同椎体成形手术方式治疗67例老年骨质疏松脊柱骨折的临床效果观察

目的：比较不同椎体成形手术方式治老年骨质疏松脊柱骨折的疗效差异。方法：收集老年骨质疏松脊柱骨折67例，按入院顺序随机分为两组，经皮椎体成形术组（PVP组）37例和后凸成形术组（PKP组）30例。比较手术前后两组患者疼痛视觉模拟评分（VAS）、病变椎体高度及脊柱后凸畸形角（Cobb角）的差异。结果：术后第7天及3、6个月，两组VAS评分与术前相比均显著下降，Cobb角与术前相比均显著缩小（P〈0.05）；PKP组椎体高度与术前相比均显著上升（P〈0.05）；且PKP组椎体高度显著高于PVP组，Cobb角显著小于PVP组（P〈0.05）。术后6个月，PKP组VAS评分显著小于PVP组（P〈0.05）。结论：经皮椎体成形术和后凸成形术均能有效缓解老年骨质疏松脊柱骨折疼痛，纠正后凸畸形，但后凸成形术更利于椎体高度恢复和后凸畸形的纠正。

Clinical Effect Observation of Different Surgical Methods Vertebroplasty for 67 Elderly Patients with Osteoporotic Spinal Fractures

Objective：To observe the clinical effects of different surgical methods vertebroplasty for elderly patients with osteoporotic spinal fractures.Method：67 elderly patients with osteoporotic spinal fractures were randomly divided into the PVP group（n=37）and the PKP group（n=30）. Then the indexes of VAS,vertebral height and Cobb angle of two groups were compared.Result：After 7 d,3,6 months of surgery,the VAS and Cobb angle of two groups were all smaller than preoperative（P〈0.05）;vertebral height of the PKP group was higher than preoperative （P〈0.05）;and vertebral height of the PKP group was higher than the PVP group,cobb angle was smaller than the PVP group（P〈0.05）. After 6 months of surgery,the VAS was smaller than the PVP group（P〈0.05）.Conclusion：All the percutaneous vertebroplasty and percutaneous kyphoplasty can effectively relieve ache,correct kyphosis for elderly patients with osteoporotic spinal fractures,but percutaneous kyphoplasty was more conducive vertebral height restoration and kyphosis correction.